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An analysis of 19 randomized placebo-controlled trials with 6,506 participants found the commonly prescribed pain drug tramadol only modestly reduced pain scores—showing improvement of just 0.93 points on a 0–10 numerical scale (97.5% confidence interval [CI], −1.26 to −0.60; p < 0.0001). The effect size fell below a minimal threshold of 1.0 point as defined by the authors. Additionally, serious adverse events were more common with tramadol (odds ratio [OR] 2.13; 97.5% CI, 1.29–3.51), particularly cardiac issues and neoplasms. Other side effects included nausea, dizziness, constipation, and somnolence. Overall, tramadol offered minimal analgesic benefit while increasing the likelihood of adverse events, suggesting its risks outweigh its limited pain relief, as published this month in BMJ Evidence-Based Medicine.
Real-world use: According to the Drug Enforcement Administration, 27.1 million prescriptions for tramadol-containing products were dispensed in 2024. Pain is the third-most common complaint in urgent care, according to a proprietary JUCM analysis of 23.4 million patient visits in 3,000 urgent cares across the United States.